Distinguishing and Diagnosing Various Presentations of Autoimmune Encephalitis: Sean Pittock, MD

WATCH TIME: 5 minutes

"We have a low threshold for considering the diagnosis. We then use tools in the clinic to help us. We take the history from the patient and see that he was perfectly well here and now has this problem that came on quite sub-acutely. They have changes on their MRI scan that could be inflammatory, or they could have an inflammatory spinal fluid. We, then, can do tests that indicate a high likelihood of something that’s immune-mediated."

Autoimmune encephalitis (AE) is a rare, complex disease that where the body’s immune system attacks healthy cells and tissues to the brain or spinal cord. It primarily affects people in their early teenage years out to age 50, and comes with numerous complications that can result in hospitalization. Treatment options for AE typically include intravenous steroids and immunoglobulins, although patients continue to have issues with cognitive deficits, fatigue, psychosocial conditions including depression and sometimes seizures.

Mayo Clinic has been among the leaders in the research and care for AE and other autoimmune disorders. They were the first to discover the aquaporin-4 antibody, which has helped distinguish diseases like neuromyelitis optica spectrum disorder from similarly appearing diseases such as multiple sclerosis (MS). To understand more about the approach to treating AE, as well as understanding different presentations of the disease, NeurologyLive^® sat down with Sean Pittock, MD.

Pittock, director of Mayo’s Center for Multiple Sclerosis and Autoimmune Neurology, discussed the numerous complications patients with AE face and why each case presents a different challenge. He also discussed the importance of biomarker testing, clinical and historical examinations to limit incorrect diagnoses.